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Parental Education for the Prevention of Plagiocephaly
Mariam Chekmeyan1, Alex Joo1, Sashrika Saini1
1From the T.H. Chan School of Medicine, UMass Chan Medical School University of Massachusetts, T.H. Chan School of Medicine.
Insights
Early parental education on preventing positional plagiocephaly (PP) reduced infant head shape abnormalities. This simple intervention can decrease PP incidence and associated healthcare costs.
Area of Science:
- Pediatrics
- Public Health
- Infant Care
Background:
- The Back-to-Sleep Campaign reduced SIDS but increased positional plagiocephaly (PP).
- PP incidence rose 5-fold, necessitating preventative strategies.
- Current educational methods may be insufficient to mitigate PP risk.
Purpose of the Study:
- To reduce the incidence of PP by enhancing parental education.
- To test if early, targeted education decreases cephalic index (CI) in infants.
- To provide a scalable intervention within existing newborn care protocols.
Main Methods:
- Infants were screened at birth; those with craniofacial disorders or prematurity were excluded.
- Head measurements (biparietal and anteroposterior) were taken to calculate CI.
- Intervention group received a video and pamphlet on PP prevention; control group did not.
Main Results:
- Thirty-nine subjects were enrolled with follow-up data.
- At 4 months, the intervention group showed a significantly lower mean CI (83.4) compared to the control group (90.6) (P=0.02).
- Baseline CI was similar between groups (82.7 vs. 83.8).
Conclusions:
- Newborn parental education effectively reduced CI, a proxy for PP.
- This intervention can decrease PP rates, parental stress, and healthcare expenditures.
- Early education is a promising strategy to address PP within safe infant sleep guidelines.
Introduction:
The American Academy of Pediatrics Back-to-Sleep Campaign significantly reduced infant mortality from sudden infant death syndrome. As a result of prolonged supine positioning, the incidence of deformational plagiocephaly has also risen 5-fold since its adoption. We aimed to improve the current educational paradigm for new parents with the goal of reducing the incidence of plagiocephaly within the confines of the Back-to-Sleep Campaign. We hypothesized that the early addition of plagiocephaly focused education for parents would reduce cephalic index, the ratio of head width to length, used as an easily measured objective proxy for positional plagiocephaly.
Methods:
Children were screened at their newborn visit. Premature newborns and those diagnosed with craniofacial disorders were excluded. For those enrolled, biparietal and anteroposterior measurements of the head were obtained using manual calipers to obtain cephalic index. Subjects randomly assigned to the intervention group were shown a 2-minute video and given an educational pamphlet on methods to prevent plagiocephaly. Unpaired 2-sample t tests comparing mean differences in intervention and control were performed.
Results:
Thirty-nine subjects were enrolled as of November 2023 with variable lengths of follow-up completed. The average baseline cephalic index for subjects in the control group was 82.7 and 83.8 for intervention group. Unpaired 2-sample t tests were performed at 2-, 4-, and 6-month time points to analyze the difference between groups. At 4 months, average cephalic index for subjects in the control and treatment group, respectively, was 90.6 and 83.4 (P = 0.02).
Significance:
Parental education at the newborn visit led to decreases in cephalic index, a proxy for positional plagiocephaly, compared with control patients. This simple intervention has the potential to reduce parental stress and healthcare costs associated with the evaluation and treatment of plagiocephaly.
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